MCLC: doctors as targets

[Denton, Kirk]

MCLC LIST
From: kirk (denton.2 at osu.edu)
Subject: doctors as targets
***********************************************************

Source: Sinosphere Blog, NYT (11/1/13):
http://sinosphere.blogs.nytimes.com/2013/11/01/doctors-the-targets-of-patie
nts-anger/

Chinese Doctors Becoming the Targets of Patients’ Anger
By DIDI KIRSTEN TATLOW

Hospital workers protesting attacks on medical staff members outside the
No. 1 People’s Hospital in Wenling, Zhejiang Province, where a man stabbed
three doctors, killing one. The large sign, left, reads “Give My Dignity
Back,” and the small sign, right, reads “Defend Justice.”

China’s hospitals are a battleground — not just for the war on illness but
also for the one between physicians and their patients.

If that statement seems extreme, consider these data points from state-run
medical organizations:

Medical staff are attacked by patients or their relatives
<http://health.sohu.com/20130816/n384302302.shtml> at a rate of once every
two weeks per hospital, according to the China Hospital Association,
Chinese news agencies reported
<http://wenku.baidu.com/link?url=M5zT0HBANld8o-dfdr2FlAcBSeMhiFKgDhRZcO6WHE
a4jCGAll4cgXL7vCrggwRW8lWYWmqzoBs1hkBqCbonNW6XFmsPXnn4B2V22tTcX2K>.

In the last two weeks there have been at least six serious incidents,
including in Guangdong Province on Oct. 21, when a Dr. Xiong Xuming was
left with adamaged eye and ruptured spleen
<http://msn.ynet.com/1183/2013/10/31/503@495502.htm> after being beaten up
by a patient’s relatives for refusing to allow them into the intensive
care unit, and in Zhejiang Province on Oct. 25, when Dr. Wang Yunjie was
stabbed to death by a patient unhappy with his treatment.

Since 2002, attacks have risen by an average of nearly 23 percent a year,
the China Hospital Management Society said in a paper published in
December inChinese Community Doctors
<http://med.wanfangdata.com.cn/searchcenter/ALLsearchInfomation.aspx?infoQu
ery=PeriodicalPaper_zgsqys-yxzy201212396>, a medical journal.

On Thursday, Prime Minister Li Keqiang addressed the issue, in a sign that
the Chinese government is seriously concerned by the mounting violence.

Mr. Li was “paying utmost attention” to the situation and had written
“important comments” requesting all government departments to take
seriously the problem of conflict between doctors and patients, according
to a post <http://e.t.qq.com/zhengfu> on the government’s official Tencent
Weibo, or microblog, account. He had ordered government departments to
take measures to “protect medical order,” it said.

The reasons for the problems in China’s health care system are, by now,
well known: a widespread lack of trust in doctors and hospital
administrators, the high cost of care, long waiting times and short
appointments — and corruption, at every level. A public that lacks basic
knowledge about medical problems and outcomes is also a factor,
commentators say.

But why turn to violence? One reason is illness can bankrupt a family.
People who exhaust their savings on care want to see positive results and
blame doctors when that’s not possible, commentators say.

While violent incidents in major cities and well-known hospitals receive
the greatest attention, the problem is actually more severe in smaller or
local hospitals, said Deng Liqiang, the head of the legal department of
the Chinese Medical Doctors Association, in an interview with Yanzhao
Metropolitan News, based in Shijiazhuang, the capital of Hebei Province.

“It’s not hard to discover that third-tier hospitals and regional medical
centers are the disaster ground for medical conflicts,” said Mr. Deng.

Underfunding by the government is a major problem, Mr. Deng said.

“In the late 1980s, the state provided about 60 percent of investment in
most public hospitals and then it fell from there,” the newspaper quoted
him as saying. “After medical reforms, by 2009, they were providing 20
percent, and the remaining 80 percent had to be covered with revenue
generated by the hospitals.”

While the government has made few comments on the substance of the
problems in the health care system, experts say another complaint of
ordinary Chinese — the concentration of good hospitals in big cities and
shortage of medical services in local communities — arises because the
state is reluctant to decentralize medical care, fearing the rise of
poorly trained medical personnel or outright quacks.

After the death of Dr. Wang, the Chinese Medical Doctors Association and
three other professional groups issued a statement urging the government
to better protect medical staff members.

“Why are doctors being injured without cease?” it asked. “In order to save
lives, doctors and patients should become friends, not enemies,” it said
<http://www.cmda.gov.cn/gongzuodongtai/zhinengbumen/2013-10-28/12497.html>.
Meanwhile, the central government’s National Health and Family Planning
Commission has announced emergency measures: Hospitals should assign one
security guard per 20 beds, and guards should account for no less than 3
percent of the total medical staff.